This proposal is the second phase of a prospective longitudinal study of the natural history of alcohol and drug use in two generations of urban American Indian families. This phase includes the age of highest risk for development of alcohol-related adverse consequences in these adolescents. An expanded feature of the proposed study is to examine both the psychological function and substance use patterns among the American Indian mothers of the adolescents, and investigate this group as a special population of interest in its own right. The following specific aims are proposed: 1) Continue to study the epidemiology of alcohol use, drug use, and psychopathology in a sample of urban American Indian adolescents. Three dependent variables that define patterns of alcohol use, adverse consequences of alcohol use, and diagnosis of abuse or dependence, have been selected for their consistency with major ongoing studies of adolescent alcohol abuse; 1a) Describe the prevalence and incidence of alcohol abuse based on patterns of alcohol use, adverse consequences of alcohol use, and diagnostic interviews; 1b) Describe the comorbidity of alcohol abuse with drug abuse and other psychopathologies; 1c) Describe the relative risk posed by adolescent alcohol abuse for suicide, school dropout, unsafe sexual activity, and other alcohol-related adverse consequences; 2) Continue to explore risk focussed models of urban American Indian adolescent alcohol and drug abuse; 2a) Develop and test an additive risk factor model using hierarchical multiple logistic regression with 16 risk factors assessed annually in the proposed grant period; 2b) Develop a reliable, and efficient screening battery for early identification of American Indian adolescents at elevated risk for alcohol and drug abuse; 3) Explore the mediating and moderating affects of conduct disorder, mother's emotional status, cultural identification, and gender between alcohol abuse and family history factors increasing risk status; 4) Study the epidemiology of alcohol use, drug use and psychopathology in a sample of urban American Indian women; 4a) Describe the prevalence and incidence of alcohol abuse based on patterns of alcohol use, adverse consequences of alcohol use, and diagnostic interviews; 4b) Describe the comorbidity of alcohol abuse with drug abuse and other psychopathologies; 4c) Describe the natural history of alcohol use in American Indian women, with particular emphasis on factors predictive of the onset and change of problematic drinking. Distinctive features of the proposal include: 1) longitudinal follow-up study of two generations from a high risk special population; 2) Demonstrated ability to recruit and minimize attrition; 3) Follow-up is community based; 4) Parallel questions for comparison to ongoing national studies; 5) Use of multiple data sources to corroborate validity of adolescent self report; and 6) Research personnel that are already trained and known in this American Indian community.